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Individual

MS. ALICE A CHADWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
13101 BRUCE B DOWNS BLVD, TAMPA, FL 33612-3803
(813) 974-0601
(813) 558-1313
Mailing address
PO BOX 917770, ORLANDO, FL 32891-7770

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
225X00000X
Occupational Therapist
Primary
OT11203
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000789400
FL
05
889079000
FL
01
Z047U
BLUE CROSS BLUE SHIELD
FL
Enumeration date
10/29/2007
Last updated
06/02/2014
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